Pectus Excavatum Heart Problems – How Serious Is It? & More

Evidence Based This post has medical citations

heart issues caused by pectus excavatum

Pectus Excavatum Heart Problems

The pectus excavatum dent causes a lot of physical pressure on the heart. The heart cannot expand like it is meant to, as in a normally shaped chest.

It has a reduced amount of space around it and is turned to the breast’s left side. Because of this, the heart operates under restrained conditions.

With each heartbeat, it carries less blood to the other parts of the body. You’ll typically feel a rapid heartbeat while the body is put through a physical struggle.

This is when increased blood volume (cardiac output) is needed.

The Heart of a PE Patient Doesn’t Pump Enough Blood

concave chest blood pump problem

The amount of blood needed is very dependent on the patient’s body size and shape. During sternal physical activity, over 10 liters of blood in a minute  may be required.

The compressed heart of the pectus excavatum sufferer has to beat more aggressively to provide the same amount of blood as in a healthy person. Contrarily, the heart of a healthy person can expand more and pump out more blood with each heartbeat.

The concave chest patients have high pulse frequencies. They also feel their “heart racing” and have limited stamina during sports. This is most evident while doing long-distance running or swimming.

Young people can tolerate a rapid heart rate easier than older sufferers.


The heart of a pectus excavatum patient is compressed. It pumps less amount of blood in comparison to a person with a normal sternum.

What did a Respected Pectus Surgeon Say?

“When we measure our pectus excavatum patients before the surgery, they often have a heartbeat of 200 or more, even after doing a small physical activity. This an unnaturally high heart rate.”

Klaus Schaarschmidt

Klaus Schaarschmidt said this in a 2012 article written in German. He is the primary physician at the children’s operational clinic at Helios Hospital Berlin, Germany.

He adds,

“If left untreated, the life expectancy of funnel chest sufferers is nearly ten years lower.”

Additionally, about ten percent of the patients will develop a problem with the heart valves. These are crushed and compressed by the indentation. This causes them to leak.

Dr. Klaus also mentions that a kid even required a heart valve replacement at the age of 16.


If the concave chest is severely deformed, it may increase heart rate during exercising to unnatural levels.

Pectus Excavatum Decreased My Heart Functionality

When I was diagnosed with congenital pectus excavatum at the age of 15, the doctors instantly informed me that it caused pressure on my heart. The X-rays showed that one of my heart valves was not functioning at full potential.

The medical team assumed this was because of a shortage of space between my breastbone and heart. The doctors said I would experience severe problems with my heart when I get older if I don’t get the deformity corrected.

That’s why the doctors wanted me to get operated. I experienced chest pain, shortness of breathing, and exhaustion every time I went running, cycling, or while I was doing any other strenuous physical activity.

However, nothing was too severe for me to realize that I suffered from an urgent medical problem. They told me that surgery would bring back normal heart function.

I Was Too Scared of a Surgery

The surgery required two titanium bars to be inserted underneath my sunken sternum, for three years. The doctor also told me there is a danger of bar dislocation and that it would be my best to avoid contact sports during these long years.

After doing internet research on my own, I found a scientific study that revealed bar dislocation could lead to heart or lung puncture, which points to excessive blood loss and can even result in death.

Just like any ordinary teenager who had high life ambitions, I was too scared of this. I wanted to live life to the fullest, go to parties, make new friends, and have the girl of my dreams sitting on my lap.

I didn’t want to spend the best years of my life in hospitals, recovering from the dangerous Nuss procedure. The icing of the cake was when the doctor told me the surgery cost was about $40.000, and that I’d have permanent scars on the sides of my chest.

When I heard about the difficulties and the operation cost, I immediately asked the doctor for an alternative solution.

A Surgery Alternative that Fixed My Chest & Heart

The doctor told me that there were only a few scientific evidences about the effectiveness of the vacuum bell therapy on restoring proper heart functioning in patients with the caved-in chest.

In addition, he mentioned that physical therapy and wearing orthoses for pectus excavatum would help me too. Nevertheless, he told me that the surgery is still his favorite treatment option for pectus excavatum.

However, he mentioned that the alternative method could be useful, but couldn’t guarantee a complete repair and healthy heart functioning with it. I proceeded to follow the second path of alternative therapy that would cost me much less, which would allow me to enjoy what I loved doing the most, and that is training.

The only cost I had was the Eckart Klobe vacuum bell and the posture brace. Today, I am back into running without any shortness of breath during the first kilometer, and my heart is no longer in danger.

Pectus Excavatum Can Cause Cardiac Arrest & Death

concave chest cardiac arrest

Patients that suffer from a severe case of pectus excavatum are prone to critical heart problems compared to milder cases. There is a scientific case of a 28-year-old man, who suffered from a severely hollowed sternum, and had two heart attacks in eight months.

After miraculously surviving the cardiac failures, doctors did Electrocardiographic investigations on him. The studies showed auricular fibrillation and recorded pause in the precordial passage, showing heart rotation.

In addition to the rotation, the angiocardiogram showed heart displacement. The cardiac catheterization revealed a cardiac performance one-half as high as the expected standard.

This means the patient’s heart was working at 50% of its capabilities. On top of that, blood flow was restricted. Doctors concluded that a severe pectus excavatum deformity could be a direct cause of a cardiac arrest and even death.


A scientific article proves connection between pectus excavatum and sudden heart attack.

2 Approaches to Restore Normal Heart Functioning with Sunken Chest

There are two recommended ways to repair pectus excavatum and restore normal heart function. The first option is the non-surgical treatment.

This is what I recommend you follow unless your deformity is causing you some serious health problems that require surgery. I chose this approach and fixed my deformity completely, while at the same time, I increased the cardiac functioning and saved a lot of money.

The second approach is a surgical procedure. It is the more painful, dangerous, and costlier option.

Surgery is scientifically proven to restore normal cardiac functioning, it still has more disadvantages than non-surgical treatment. The surgical procedure is sometimes a must because the concave chest is critically squeezing the lungs and heart.

Nevertheless, if this were the case, you’d probably get operated before your teenage years.


Correcting pectus excavatum surgically or non-surgically can both be effective.

Pros & Cons of Pectus Surgery

The Nuss procedure is the most effective and most widely used pectus excavatum surgery.

The surgery is categorized as minimally invasive. However, you should know that there are plenty of reported cases of heart injury and death​ following the Nuss procedure.

Throughout the surgery, the sunken sternum is raised to a normal position. Two steel bars are inserted underneath the breastbone through small cuts on the side of the chest.

They are attached to the ribs with stitches. The steel bars stay in place for about three years. Sometimes, it may require more time than that.

The goal of the surgery is the chest to adjust, and stay in the new position, permanently. The chest form and appearance will drastically improve, which will help the patient deal with the adverse psychological effects that may affect the sufferer.

It is typical for patients to feel improvements in breathing and stamina after the surgery. Also, it will result in higher exercise tolerance than before.

However, the Nuss procedure’s outcome can vary depending on the patient’s age at the time of surgery. Scientific data reveals that early age correction yields better results.

For example, if you undergo surgery during adulthood, there is a high chance of deformity recurrence. If you’re more than 20 years old and still haven’t undergone surgery, I highly recommend you follow the non-surgical treatment approach.


Even though a surgery may be effective, there are scientifically proven risks that doctors don’t want to inform you about.

Non-Surgical Therapy Benefits on Cardiac Health

improve heart health with vacuum bell

You can restore normal heart functioning without undergoing surgery. The way you do it is through vacuum bell therapy, wearing corrective pectus excavatum braces, following a proven exercise program, stretching the tight musculature that causes poor posture and diaphragmic breathing.

Click on the links above to read how to learn more about this. Like I said above, I corrected my deformity successfully without surgery.


Non-surgical treatment of a sunken chest is scientifically proven to be effective.

Heart Murmur is Caused by Pectus Excavatum

heart murmur and concave chest

Consider a 2013 study led by cardiologist Shuji Hashimoto. They concluded pectus excavatum is a cause of heart murmur. A 33-year-old man with a moderate severity of pectus excavatum was examined during the study.

The heart murmur caused by his sunken sternum was audible during both standing and sitting. However, the doctor’s diagnosis concluded that the intensity of his heart murmurs increased with postural change.

This happened because his irregular anterior chest wall pushed the pulmonary artery when standing. Now that we resolved that pectus excavatum is linked to heart murmurs, read the following to get more familiar with it, and whether this condition is harmful to your health.

Is Heart Murmur Dangerous?

Even though a heart murmur doesn’t require therapy, you must visit a doctor to ensure the pectus excavatum deformity doesn’t cause a severe heart problem. Heart murmurs are swishing or wheezing noises that occur during your heartbeat cycle.

It is caused by uncontrolled blood in or around your heart. It is the most frequent irregular heart sound. If you have this, a health care provider can hear it through a stethoscope.

Heart murmurs are commonly genetic (you are born with it). However, they can grow later in your life, especially if you suffer from the pectus excavatum deformity.

A heart murmur isn’t a disease or a disorder. But, it can indicate an underlying heart issue that you may not be aware of.

10 Symptoms of Heart Murmur

Generally, you may have a heart murmur, but you aren’t aware of it. You can check the following symptoms, as stated by Mayo Clinic to help you detect whether you suffer from it.

  • Suffering from a pectus excavatum deformity
  • Bluish skin discoloration, particularly on the fingers and lips
  • Heart and chest ache
  • Lightheadedness or fainting, especially during a physical activity
  • Expansion of the neck veins and liver
  • Unreasonable sweating irrelevant to warmth or exercise
  • Unwillingness to eat and abnormal growth in infants and children
  • Breathing difficulties through physical effort
  • Swelling in the toes, legs, or stomach
  • An abnormal increase in weight


Pectus excavatum can cause heart murmur. You may not be aware of it, because it can only be heard through stethoscope.

Three Scientific Cases of Pectus Excavatum and Cardiac Tamponade


A 2017 Korean study, supported by the Yeungnam University, reveals how a 23-year-old female patient that underwent the Nuss procedure to correct her pectus excavatum needed an emergency treatment with clinical signs of cardiac tamponade.

The syndrome occurred 16 and 18 months after a successful Nuss procedure. The study concluded that the Nuss procedure could lead to life-threatening conditions, such as cardiac tamponade.

The surgery can manifest as early or delayed complications, such as in this case. The doctors healed the 23-year-old successfully with a mixed therapy of oral anti-inflammatory medications and surgical drainage.

To keep yourself healthy post-surgically, you must always follow up in the outpatient clinic.

Second CASE

The second case of pectus excavatum linked with cardiac tamponade was investigated in a 2004 UK study by M. J. Barakat and J. A. Morgan. A 24-year-old guy required immediate emergency surgery because of clinical signs of cardiac tamponade.

It was caused by a sternal wire from a pectus excavatum surgical repair that happened two years earlier. It has cracked and pierced through the pericardium, leading to epicardial damage and a haemopericardium.

Third CASE

The third case of a late complication after a funnel chest surgery happened to a 12-year-old kid. It happened two years after a successful surgical repair. A hemopericardium and tamponade occurred because a fractured metal plate in the pericardium penetrated the right atrium.

This case was scientifically researched in a 1991 Italian study led by Elami A. and Lieberman Y. All these scientific articles point out that life-threatening complications like tamponade may occur, even years after a successful pectus excavatum surgery.

What is Cardiac Tamponade?

cardiac tamponade and sunken chest

Cardiac tamponade is a disorder caused by an increase of fluid in the pericardial area (the pouch around the heart). After the fluid builds up, it results in decreased ventricular filling and subsequent hemodynamic compromise.

In other words, it leads to heart compression. In addition to fluid, the heart can also accumulate blood clots, pus, gas, and blood. The occurrence of this syndrome requires a medical emergency .

The complications involve pneumonic edema, shock, and even death.

4 Indicators of Cardiac Tamponade

Symptoms are usually the same as those in cardiogenic shock. If you feel any of the following signs of cardiac tamponade, seek immediate medical treatment.

  • Shortness of breathing
  • Physical and mental tiredness
  • Feeling that you may faint
  • Nagging cough

A 2003 study by David H. Spodick, medically approves these symptoms.


Cardiac tamponade can occur years after a pectus excavatum surgery. If you notice any symptoms, please rush to the hospital, because it can be deadly.

Enlarged Heart & Concave Chest Scientific Proof

A 1973 scientific research proves that the pectus excavatum deformity can cause an enlarged heart. A 21-year-old male with a concave chest was evaluated for cardiomegaly (enlarged heart).

He had a very rapid heartbeat and had no other indication of a heart disorder. His physical medical test was healthy, except that he had a mild dent in his chest. The study proved that the pectus excavatum deformity caused an enlarged heart in this patient.

An enlarged heart can enhance the danger of heart failure.

In that case, the heart muscle weakens and isn’t capable of pumping enough blood to the rest of your body. Also, it can cause blood clots. If they access the bloodstream, they can hinder blood flow to essential organs, leading to stroke or cardiac arrest, which can be fatal.


Pectus excavatum can cause enlarged heart which can lead to heart failure.

Cardiac Arrhythmia and Pectus Excavatum

irregular heart beat and inverted chest

Pectus excavatum is closely related to cardiac arrhythmia (irregular heartbeat). There is a bright piece of scientific proof that confirms this.

The study examines how a 24-year-old lady was brought to the emergency room with a rush of heart palpitations. Upon testing, the female patient was discovered to have the pectus excavatum condition.

The deformity causes the breastbone to compress the right ventricular wall, leading to a reduced right ventricular ejection fraction. When you combine this with right atrial enlargement and pulmonary hypertension, the patient will probably suffer from cardiac arrhythmia.

In addition to the first study, a recent 2017 research reported a 14-year-old kid with severe pectus excavatum diagnosed with cardiac arrhythmia. His irregular heartbeat lasted for around 15 minutes on average.

Other than the sunken chest, the kid was perfectly healthy. He had no other cardiovascular symptoms, and his medical records were excellent. Doctors decided to repair his indented chest deformity with a minimally invasive Nuss procedure.

After correcting the deformity, heart arrhythmia was also solved. This directs to a direct relationship between pectus excavatum and cardiac arrhythmia.


Irregular heartbeat is one of the most common cardiac symptoms of pectus excavatum.

Fast Heart Rate & Pectoralis Excavatum

A study done in 2009 revealed a close connection between pectus excavatum and rapid heart rate, especially after exercise. In the study, an older person who was physically active complained of a racing heart and trouble with breathing after doing physical exercise.

The doctors tested him on an electrocardiogram, which revealed 220 heartbeats a minute. This is very high, especially after resting for a long time after doing the exercises.

After that, health checks were done on the 59-year-old gentleman. Surprisingly, no underlying illness was found. The sufferer’s rapid heartbeat even got worse, and it motivated him to do a web search, which pointed out that the pectus excavatum was the leading cause of his heart problems.

After consulting with a thoracic surgeon, he underwent a Ravitch procedure that repaired his deformity. Shortly after the surgery, the patient was free of shortness of breath and fast heart rate. Three months after surgery, the 59-year-old man could freely continue to do substantial physical exercises.

The study figured out that if you suffer from pectus excavatum, it is common to experience racing heartbeat and overall fatigue after exercise. Repairing the deformity will also lead to the correction of your heart problems.


If pectus excavatum affects your cardiac and pulmonary functioning, you may feel fast heart rate after doing a sternous physical activity.


The pectus excavatum deformity is more harmful your health that you’ve previously thought. It can directly affect its functioning. The heart is probably the most crucial organ in your body that is always required to perform optimally.

If you suffer from the inverted chest deformity, please see a cardiologist or a thoracic surgeon that has experience dealing with it. Even if you don’t feel any symptoms, there may be an underlying heart problem that requires immediate treatment.


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